Who is going to intervene or rein in ?

[dhpath]

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Members don't see this ad.

http://www.nejm.org/doi/full/10.1056/NEJMsa1201141?query=TOC

Wake up CMS and ACA leaders.
POD lab, POD radiology and POD radiation oncology need to stop.

 

[WEBB PINKERTON]

They will just slash reimbursement some more to kill off all this self referal.

 

[Pathwrath]

They will just slash reimbursement some more to kill off all this self referal.

This.

Why correct abuse by using a surgical strike against powerful clinician interests, when you can just apply a sledgehammer to the whole profession.

 

[Johnny Sunshine]

Then they will move to require all physicians to accept medicare/medicaid patients, and their failure will be complete.

 

[KluverB]

It's all the millennials' fault.... http://m.townhall.com/columnists/ku...als-not-to-vote-for-your-own-serfdom-n1733722

 

[dhpath]

It's all the millennials' fault.... http://m.townhall.com/columnists/ku...als-not-to-vote-for-your-own-serfdom-n1733722

Physicians are the abusers (our own clan), not republican or democrats (or both), certainly not the fault of the millennials'

 

[LADoc00]

Ironically podlabs maybe the last best hope for most to keep Pathology in their community. Without them and their obvious inducements, specimens get taken away to national level mega labs who can churn a profit by billing Medicare out of high reimbursement localities.

So actually YOU need to wake up and make Podlabs work for you. That or have nothing.

Posts like this reveal the naivete most of the our colleagues are suffering from. They see what they think is cause and effect and lash out without understaning ANY of the underlying dynamics.

This reinforces my view that 90%+ of smaller pathologist owned outpatient labs will die in the next decade.

Adapt or die they say and it appears many of our professional colleagues have chosen to shake their fist at the sky and just go down with the ship...

 

[Silent Cool]

Then they will move to require all physicians to accept medicare/medicaid patients, and their failure will be complete.

JS, it looks like that day is already here:

http://www.standfirminfaith.com/?/sf/page/30950
'Virginia Democrat Calls for Law to Force Physicians to Accept Medicare/Medicaid'

 

[WEBB PINKERTON]

Ironically podlabs maybe the last best hope for most to keep Pathology in their community. Without them and their obvious inducements, specimens get taken away to national level mega labs who can churn a profit by billing Medicare out of high reimbursement localities.

So actually YOU need to wake up and make Podlabs work for you. That or have nothing.

Posts like this reveal the naivete most of the our colleagues are suffering from. They see what they think is cause and effect and lash out without understaning ANY of the underlying dynamics.

This reinforces my view that 90%+ of smaller pathologist owned outpatient labs will die in the next decade.

Adapt or die they say and it appears many of our professional colleagues have chosen to shake their fist at the sky and just go down with the ship...

Wait a minute, you have posted some very negative things about in-office labs in the past. Did you finally go over to the dark side?

http://forums.studentdoctor.net/thr...gists-should-get-10-for-reading-88305.963862/

http://forums.studentdoctor.net/thr...-thinks-pathologists-should-thank-him.967389/


Anyways, I thought hospitals were just going to buy up virtually all practices, make the physicians use the local hospital employed pathology group. Isn't that the hope?

One thing is for sure, goodbye independent pathology labs in 2014. It is game over.

 

[LADoc00]

YES I went over to the Dark Side! In fact I sign out cases in a full on Dark Vader prop outfit I got at Comic-Con. If I could find a residency class nearby and the time to visit, I would cut them down with my evil red lightsaber too!! So there.

Emperor Palpatine is the President and controls the Imperial Senate...we are all doomed until the one jedi comes to free us.

 

[pathstudent]

Ironically podlabs maybe the last best hope for most to keep Pathology in their community. Without them and their obvious inducements, specimens get taken away to national level mega labs who can churn a profit by billing Medicare out of high reimbursement localities.

So actually YOU need to wake up and make Podlabs work for you. That or have nothing.

Posts like this reveal the naivete most of the our colleagues are suffering from. They see what they think is cause and effect and lash out without understaning ANY of the underlying dynamics.

This reinforces my view that 90%+ of smaller pathologist owned outpatient labs will die in the next decade.

Adapt or die they say and it appears many of our professional colleagues have chosen to shake their fist at the sky and just go down with the ship...

If fee splitting with the clinicians is your best case scenario then the field if pathology truly is a wasteland.

 

[WEBB PINKERTON]

YES I went over to the Dark Side! In fact I sign out cases in a full on Dark Vader prop outfit I got at Comic-Con. If I could find a residency class nearby and the time to visit, I would cut them down with my evil red lightsaber too!! So there.

Emperor Palpatine is the President and controls the Imperial Senate...we are all doomed until the one jedi comes to free us.

My hatred of in-office labs has cooled off a little. I'd still wouldnt mind seeing them all die off though. If they do bite the dust, you are right it won't help the local pathology groups. You just get the return of client billing hell and every slimeball pathology lab in the country acting like a 5 dollar ***** to get the business. Although there will be far fewer labs left to compete with in 2014 and beyond thanks to CMS.

Glad to be exiting the cesspool.

 

[Doormat]

My hatred of in-office labs has cooled off a little. I'd still wouldnt mind seeing them all die off though. If they do bite the dust, you are right it won't help the local pathology groups. You just get the return of client billing hell and every slimeball pathology lab in the country acting like a 5 dollar ***** to get the business. Although there will be far fewer labs left to compete with in 2014 and beyond thanks to CMS.

Glad to be exiting the cesspool.

Very well said.

I would be nice to see in-office labs fail. I'd pick up histology equipment at fire sale prices and make a some calls to gloat to my so-called colleagues in the community who fancy themselves pathologists but are actually piggy banks.

Even if self-referral labs disappear, it's very true that high-earning specialists will simply turn to client billing in the 36 states that allow it. Megalabs with large scale will compete for the very low margin business of providing clinical lab and anatomic path services at rock-bottom prices. A GI/uro/derm who used client billing and self-referral to increase their income by 20-30% may only be able to increase it 5-10%, marginally taxed at a federal income tax rate of 39.6% along with a 3.8% medicare surtax on earned income >200K per year. In California add another 13% marginal state income tax for a total of 56.4% taxation on kickback income.

 

[Pathwrath]

It's time to shut 'em all down. Shut them the hell down! And I say this as one who has gritted his teeth and adapted to the new world order. The TC cuts have made the fat clinician owners squeal like stuck pigs and I'm tired of their greedy crap. Client billing at least allows me to work in my lab with my oversight, not signing out junk in some scope mill closet. Shut them down.

 

[WEBB PINKERTON]

Client billing is just as bad. It's no improvement. It may actually be worse

 

[Pathwrath]

Worse than 10 bucks a biopsy?! I'd do better with client billing than in-office. My lab can compete with megalabs--is already competing with megalabs. Famous last words and all, but in-office has gone from horrible to revolting.

 

[WEBB PINKERTON]

I've seen client pricing on the TC for 10 bucks or less. There was a notorious derm lab in my area doing this when it was legal in my state. They even took a big account from our group. I'm suprised the pathologists working there didnt get pulmonary emboli from pushing so much glass. Hell, maybe some did.

If the pathologist job market isnt saturated, why is there so much of this garbage going on? It's the best indicator that the market is flooded and we are producing too many pathologists.

 

[Pathwrath]

I meant ten bucks for reading in-office biopsies. Ten bucks on the TC is ten bucks more than I'm getting from in-office work.

Don't get me wrong--even writing this makes me nauseous. I'm not saying things will be great if in-office labs close. I am just sick of them.

 

[Tissue issue]

I've seen client pricing on the TC for 10 bucks or less. There was a notorious derm lab in my area doing this when it was legal in my state. They even took a big account from our group. I'm suprised the pathologists working there didnt get pulmonary emboli from pushing so much glass. Hell, maybe some did.

If the pathologist job market isnt saturated, why is there so much of this garbage going on? It's the best indicator that the market is flooded and we are producing too many pathologists.

I agree. Additional evidence- http://www.ascp.org/PDF/Fellowship-Reports/ASCP-Fellowship-Job-Market-Surveys.pdf

Some quotes:
"Conclusions:
About 40 percent of fellows confirmed plans to complete additional fellowship training, defined as two or more pathology fellowships before entering the job market.

The job situation for pathology fellows is mixed; most receive one or more offers, but a substantial minority is not finding employment right away."

A few who post here do not seem troubled about the substantial minority.